Effect of health insurance on direct hospitalisation costs for in-patients with ischaemic stroke in China

2018 ◽  
Vol 42 (1) ◽  
pp. 39 ◽  
Author(s):  
Ma Yong ◽  
Xiong Xianjun ◽  
Li Jinghu ◽  
Fang Yunyun
Keyword(s):  
Health Insurance ◽  
Cerebrovascular Disease ◽  
Financial Burden ◽  
Reimbursement Rate ◽  
Financial Investment ◽  
Hospitalised Patients ◽  
The Government ◽  
Set Up ◽  
The Cost ◽  
Out Of Pocket Costs

Objectives The aim of the present study was to determine the direct medical costs of hospitalisations for ischaemic stroke (IS) in-patients with different types of health insurance in China and to analyse the demographic characteristics of hospitalised patients, based on data supplied by the China Health Insurance Research Association (CHIRA). Methods A nationwide and cross-sectional sample of IS in-patients with International Classifications of Diseases 10th Revision (ICD-10) Code I63 who were ensured under either the Basic Medical Insurance Scheme for Employees (BMISE) or the Basic Medical Insurance Scheme for Urban Residents (BMISUR) was extracted from the CHIRA claims database. A retrospective analysis was used with regard to patient demographics, total hospital charges and costs. Results Of the 49588 hospitalised patients who had been diagnosed with IS in the CHIRA claims database, 28850 (58.2%) were men (mean age 67.34 years) and 20738 (41.8%) were women (mean age 69.75 years). Of all patients, 40347 (81.4%) were insured by the BMISE, whereas 8724 (17.6%) were insured by the BMISUR; the mean age of these groups was 68.55 and 67.62 years respectively. For BMISE-insured in-patients, the cost per hospitalisation was RMB10131 (95% confidence interval (CI) 10014–10258), the cost per hospital day was RMB787 (95% CI 766–808), the out-of-pocket costs per patient were RMB2346 (95% CI 2303–2388) and the reimbursement rate was 74.61% (95% CI 74.48–74.73%). For BMISUR-insured in-patients the cost per hospitalisation was RMB7662 (95% CI 7473–7852), the cost per hospital day was RMB744 (95% CI 706–781), the out-of-pocket costs per patient were RMB3356 (95% CI 3258–3454) and the reimbursement rate was 56.46% (95% CI 56.08–56.84%). Conclusions Costs per hospitalisation, costs per hospital day and the reimbursement rate were higher for BMISE- than BMISUR-insured in-patients, but BMISE-insured patients had lower out-of-pocket costs. The financial burden was higher for BMISUR- than BMISE-insured in-patients. For BMISUR-insured in-patients, the out-of-pocket payment was 43.54% of total expenses, which means the government should increase the financial investment, raise reimbursement rates and set up differential reimbursements to meet the health needs of in-patients with different income levels. What is known about the topic? Cardiovascular and cerebrovascular diseases are major non-communicable diseases affecting the health of the Chinese population. The China Health Statistics Yearbook (2013) reported that across all in-patients, 195million (5.82%) had been discharged with a diagnosis of cerebrovascular disease. Of these, 118million had IS, accounting for 60.51% of all in-patients with cerebrovascular disease and 54.97% of hospitalisation costs for all cerebrovascular disease in-patients. After the two basic insurance systems, namely the BMISE and BMISUR, had been established, the out-of-pocket expenses for patients were reduced. However, to date there have been no studies investigating how the different types of health insurance (i.e. the BMISE and the BMISUR) affected the costs of treatment of IS in-patients in China. What does this paper add? This paper reports the direct costs for patients diagnosed with IS based on data supplied by the CHIRA. Direct hospitalisation costs depending on the type of insurance cover, age and gender were also evaluated. What are the implications for practitioners? The present study found that the personal financial burden of disease treatment was higher for in-patients insured under the BMISUR than BMISE. For in-patients insured under the BMISUR, the out-of-pocket payment was 43.54% of total expenses, which means the government should increase the financial investment, raise reimbursement rates and set up differential reimbursement rates to meet the health needs of patients with different incomes.

Abstract 18272: The Increasing Proportion of Acute Myocardial Infarction Represented by the Uninsured: a Growing Financial Burden in the United States

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bethany Doran ◽  
Yu Guo ◽  
Jinfeng Xu ◽  
Sripal Bangalore
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Financial Burden ◽  
Insurance Coverage ◽  
The United States ◽  
The Us ◽  
Hospital Stays ◽  
Nationally Representative ◽  
The Cost

Introduction: Under the provisions of the Affordable Care Act, insurance coverage will markedly increase with the Congressional Budgetary Office estimating the number of insured to increase by approximately 13 million in 2014 and 25 million in 2016. However, approximately 31 million non-elderly US citizens are expected to remain without health insurance in 2016. Acute myocardial infarction (AMI) remains a source of significant morbidity and mortality, as well as cost to society. No prior studies have examined temporal rates of uninsured among patients presenting with an AMI using a nationally representative database. Hypothesis: We tested the hypothesis that the proportion of uninsured individuals with AMI and cost of uninsured to society will vary by year. Methods: We used the Nationwide Inpatient Sample (NIS), which contains estimates from approximately 8 million hospital visits and information related to number of discharges, aggregate charges, and principal diagnoses of all patients discharged in the US. We calculated the percentage of acute myocardial infarction by insurance status, and the sum of all charges of hospital stays in the US adjusted for inflation. Results: The cost to society due to acute myocardial infarction in the uninsured increased substantially from 1997 to 2012, with total cost in 1997 of $852,596,272 and $3,446,893,954 in 2012 after adjustment for inflation. In addition, although rates of AMI decreased in the general population (from 268.6/100,000 individuals in 1997 to 193.8/100,000 individuals in 2012), the proportion of individuals with AMI who were uninsured increased (from 3.83% in 1997 to 7.37% in 2012). Conclusions: The proportion of those experiencing AMI who are uninsured is rising, as is cost to society. It remains to be seen what the effects of expanding health insurance will have on the rate of AMI as well as proportion of AMI represented by the uninsured.

scholarly journals Private health insurance and the Pharmaceutical Benefits Scheme: how effective has recent government policy been?

2004 ◽  
Vol 28 (1) ◽  
pp. 34 ◽  
Author(s):  
Jeff R J Richardson ◽  
Leonie Segal
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Public Hospitals ◽  
Common Element ◽  
Cost Shifting ◽  
The Public ◽  
Pharmaceutical Expenditures ◽  
The Government ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The cost to government of the Pharmaceutical Benefits Scheme (PBS) is rising at over 10 percent per annum. The government subsidy to Private Health Insurance (PHI) is about $2.4 billion and rising. Despite this, the queues facing public patients ? which were the primary justification for the assistance to PHI ? do not appear to be shortening. Against this backdrop, we seek to evaluate recent policies. It is shown that the reason commonly given for the support of PHI ? the need to preserve the market share of private hospitals and relieve pressure upon public hospitals ? is based upon a factually incorrect analysis of the hospital sector in the last decade. It is similarly true that the ?problem? of rising pharmaceutical expenditures has been exaggerated. The common element in both sets of policies is that they result in cost shifting from the public to the private purse and have little to do with the quality or quantity of health services.

Financial toxicity of cancer treatment at a diverse county hospital.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 76-76
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Debeshi Maitra ◽  
Sangeeta Aggarwal ◽  
Manali I. Patel
Keyword(s):  
Sex Education ◽  
Low Income ◽  
Cancer Care ◽  
Financial Burden ◽  
Education Level ◽  
Financial Toxicity ◽  
Demographic Information ◽  
Significant Difference ◽  
The Cost ◽  
Out Of Pocket Costs

76 Background: The rising costs of cancer care increasingly results in financial distress for patients and their families. Low-income patients face a greater burden of financial toxicity, but few studies have characterized what factors contribute to this, and what interventions can relieve toxicity. Methods: From October 2017 to December 2017, we used a validated COST survey tool to understand the extent of financial burden that patients with cancer experience. We surveyed patients who receive their oncology care in a medical system that serves predominantly minority and low-income patients in Santa Clara County. We collected demographic information including sex, education level, ethnicity, income, insurance status, monthly out of pocket costs (OOPC) and employment status prior to diagnosis. We used a multivariable linear regression to study the association between the patient factors and financial burden as demonstrated by the COST score. All data were analyzed using Stata 14. Results: Demographic information is presented in Table 1. A total of 152 patients completed all 11 items of the COST survey. In the multivariate model, there was no significant difference in COST score by sex, education level, or ethnicity. However, income ≤$25,000 was associated with higher COST scores (p = 0.019), as was higher monthly OOPC (p = 0.003). Medicare patients and patients who were employed prior to diagnosis tended to have higher COST scores although not quite statistically significant (p = 0.057, p = 0.083). Conclusions: Patient-reported financial toxicity is an unmet concern among patients in this single institution study with a high proportion of underinsured patients. Higher OOPC and low income was associated with a higher financial burden. These findings suggest that patients would benefit from targeted interventions to mediate out of pocket costs of cancer care.[Table: see text]

Employment Rank and the Choice of Health Insurance Benefit Scheme among Bangladeshi Civil Servants

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Syed Abdul Hamid ◽  
Afroza Begum ◽  
Syed M Ahsan ◽  
Sushil Ranjan Howlader ◽  
Azhar Uddin ◽  
...  
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Civil Servants ◽  
Fiscal Capacity ◽  
Insurance Benefit ◽  
Sharing Rules ◽  
The Government ◽  
Basic Salary ◽  
Very High ◽  
High Willingness

Abstract This study surveys 622 Bangladeshi civil servants of all administrative jurisdictions and elicits their preference for health insurance schemes. The latter vary in the amount of sum assured as well as in terms of premium sharing rules with the government. The paper also explores the financial burden that the premium subsidy may impose on the exchequer and the state’s fiscal capacity to shoulder it. We discover a very high willingness to join the scheme. Though all three premium-sharing options posit flat rates common for all employment ranks, respondents appear to prefer premiums proportional to their basic salary.

Private Agencies for Public Purposes: Some New Perspectives on Policy Making in Health Insurance Between the Wars

1983 ◽  
Vol 12 (2) ◽  
pp. 165-193 ◽  
Author(s):  
Noelle Whiteside
Keyword(s):  
Health Insurance ◽  
Interwar Period ◽  
Social Insurance ◽  
Central Regulation ◽  
Insurance Policy ◽  
Public Subsidies ◽  
The Government ◽  
The Cost ◽  
The Unemployed

ABSTRACTThe approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that – in the light of recent discussions about reviving a system of national health insurance – we have much to learn from looking again at the experience of the interwar period.

scholarly journals The cost of violence: Assessing the economic cost of gender-based violence in Rwanda

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Spence
Keyword(s):  
Financial Burden ◽  
National Level ◽  
Economic Cost ◽  
Legal Issue ◽  
Gender Based Violence ◽  
The Common ◽  
The Government ◽  
Gender Based ◽  
The Cost ◽  
Minimum Costs

Abstract Background Gender-Based Violence (GBV) is a health and legal issue of international concern. In 2006, the Rwandan Government passed new laws to address this issue. However, Rwanda still has a high prevalence of gender based violence in communities at a rate of around 35%. This poster explores the economic cost of Gender-Based Violence in Rwanda. It seeks to: (1) define and describe GBV in Rwanda and comment on the state of the economy; (2) examine the literature on existing studies of the cost of GBV with a focus on common methodologies used; and (3) calculate the minimum costs associated with GBV in Rwanda. Methods Existing data was reviewed to look at the definition of GBV with regard to law and policy. This included identifying the common causes of GBV in Rwanda as well as looking at the nature and prevalence. An examination of the current state of the Rwandan Economy was undertaken in order to identify the areas whereupon GBV could cause disruption. Subsequently, a narrative literature review was conducted which examined the common methodologies used in cost analyses of GBV across the globe. Lastly a basic costing exercise was performed which determined the minimum costs associated with GBV in Rwanda using government data and NGO reports. Results The results showed that GBV makes up a small percentage of GDP in Rwanda at 0.003%. Victim costs were measured at $10,355,812.97, whilst government costs were found to be $13,082,542.07 and civil society costs incurred amounted to $4,684,428.00. Conclusions Overall this study reveals that just taking basic costs into consideration, GBV imposes a significant financial burden on the country. In particular, it highlighted the burden felt by the government providing public services such as healthcare and legal services. Therefore it is likely there is an overconsumption of scarce resources by GBV cases, which will likely lead to economic strain at both a local and national level. Key messages Gender-based violence costs make up a small but recognisable percentage of GDP in Rwanda. More investment in preventative strategy is needed to reduce both the prevalence of GBV and the cost to the local and national economy.

scholarly journals ANALYSIS OF MANAGEMENT AND UTILIZATION OF CAPITATION FUND DENTISTS IN THE CITY OF PALEMBANG AND LUBUKLINGGAU

2020 ◽  
Vol 15 (2) ◽  
pp. 162
Author(s):  
Faiznur Ridho ◽  
Bambang B. Soebyakto ◽  
Haerawati Idris
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Fee For Service ◽  
Ideal Number ◽  
The Government ◽  
The Cost ◽  
The City ◽  
The Ideal

Primary dentists at the era of the National Health Insurance are only paid IDR2,000 each patient. The Capitation funds can not cover the cost of services that must be spent. The payment system must be improved because it is related to the quality of service. The aims of this study to analyze the management and utilization of  dental capitation funds including the bottlenecks and to generate solutions in the implementation of JKN. This research was descriptive with qualitative approach. The informants of the study were 16 (sixteen) dentists as an independent practitioners and pratama clinics in Palembang and Lubuklinggau with highest and lowest capitation coverage. Data were analyzed by data reduction, data presentation, conclusion drawing and verification. The result showed that there was a disparity in capitation fund income received by dentists both as an independent practitioners and pratama clinic. Not all dentists get the ideal number of participants 1: 10,000. Dentists with low capitation norms have difficulty to set their operational funds. The budget for operational cost is bigger than services cost. Revenues compared to capitation funds are still lacking. Most capitation funds for primary dentists are insufficient and still rely on fee for service patients. The government  should set dental capitation norm and regulation for National Health Insurance era.Key words: dentist, capitation, clinic, utilization, regulation

scholarly journals Application of Machine Learning Techniques to Predict the Impact of Health Insurance on the Wellbeing of an Individual

2019 ◽  
Vol 9 (2) ◽  
pp. 3065-3070
Keyword(s):  
Machine Learning ◽  
Health Insurance ◽  
Large Scale ◽  
Insurance Industry ◽  
Financial Burden ◽  
Machine Learning Algorithms ◽  
Machine Learning Techniques ◽  
Insurance Companies ◽  
The Government ◽  
The Impact

The healthcare domain in India has suffered considerably despite the advancement in technology. Several financing schemes are endorsed by the insurance companies to lessen the financial burden faced by the government and people. Nonetheless, Health Insurance segment in India remains underdeveloped due to various complexities that it faces. This paper exploits a heuristic sampling approach combined with the ensemble Machine Learning algorithms on the large-scale insurance business data to realize the current shape of the Health Insurance industry in India. Through the courtesy of Data Mining and Data Analytics, it is plausible to furnish insights that assist the common people in acquiring closure that helps in the process of decision making.

scholarly journals Optimal Health Insurance and Trade-Off between Health and Wealth

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yan Zhang ◽  
Yonghong Wu
Keyword(s):  
Health Insurance ◽  
Financial Burden ◽  
Treatment Plan ◽  
Research Work ◽  
Control Technique ◽  
Numerical Illustration ◽  
Trade Off ◽  
Property Insurance ◽  
Optimal Health ◽  
Set Up

Health insurance is considered to be a special type of nonlife insurance with two important features. First, compared with property insurance, health insurance provides valuable hedge against unpredictable shocks to health status, instead of loss on property. Therefore, a modified utility function that describes the trade-off between health and wealth should be applied in optimal indemnity design. Second, in the case that the insured is severely or critically ill, with necessary medical treatment, the insured may not fully recover from an illness or an injury. The doctor usually communicates with the patient to set up a personalized treatment plan and explains clearly about the expected outcome beforehand. Hence, there is some probability that health insurance helps to rescue the insured from disastrous financial burden, but it still yields a lower utility of health. By taking these special features into account, we formulate the optimization problem and characterize the optimal solutions via the Lagrange multiplier method and optimal control technique. Finally, we examine our optimal contracts by numerical illustration. Our research work gives new insights into health insurance design.

scholarly journals Present status of renal replacement therapy in Asian countries as of 2017: Vietnam, Myanmar, and Cambodia

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Toru Hyodo ◽  
Masafumi Fukagawa ◽  
Nobuhito Hirawa ◽  
Yoshitaka Isaka ◽  
Hidetomo Nakamoto ◽  
...  
Keyword(s):  
Economic Development ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Present Status ◽  
Academic Research ◽  
Asian Countries ◽  
Dialysis Therapy ◽  
The Government ◽  
The Cost

AbstractSince 2015, the Committee of International Communication on Academic Research of the Japanese Society for Dialysis Therapy has held its Asian symposium during the society’s Annual Congress to discuss the present status of and demand for dialysis therapy in Asian countries. The aim of the symposium is to identify needs and find ways to contribute in the area of dialysis therapy in these countries. Three manuscripts are presented here by participants at the 2017 Asian symposium from Vietnam, Myanmar, and Cambodia.With economic development, hemodialysis (HD) therapy is now available worldwide. However, the cost of HD is very high compared with the average income in these three countries and, as of 2017, Cambodia and Myanmar have not yet established national health insurance systems. In Cambodia, patients must bear 100% of the cost for dialysis. In Myanmar, the government covers the cost of HD (20 USD, 40% of total cost) in public HD centers, but this service is still insufficient to meet current demand, with long waiting lists of up to 6 months at government HD centers. In contrast, in Vietnam, dialysis is almost completely covered by national health insurance. Dialyzers tend to be reused in all three countries. Continuous ambulatory peritoneal dialysis is available in Vietnam and Myanmar but not in Cambodia. Viable health insurance systems should be established as soon as possible in Cambodia and Myanmar, although this will ultimately depend on the countries’ level of economic development.

Sign in / Sign up

Export Citation Format

Share Document